The Psychiatrist 

About: The Psychiatrist is an academic journal. The journal publishes majorly in the area(s): Mental health & Service (business). It has an ISSN identifier of 1758-3217. Over the lifetime, 5241 publications have been published receiving 35511 citations.

National Service Framework for Mental Health

Abstract: The National Service Framework for Mental Health (NSF—MH) is a strategic blueprint for services for adults of working age for the next 10 years. It is both mandatory, in being a clear statement of what services must seek to achieve in relation to the given standards and performance indicators, and

The Health of the Nation

Abstract: The Health of the Nation — A Strategy for England is a national response to WHO's Health for All by the Year 2000 initiative. It has great importance both because it focuses on health outcomes and because it selects mental illness as one of five priority areas. This article traces the historical background to the development of the White Paper, summarises the content of the mental illness key area and current progress in improving information and understanding and developing comprehensive services, and improving good practice. It draws out the implications for individual practitioners, users and cares, and for the working arrangements between purchasers and providers.

The Hospital Anxiety and Depression Scale

Abstract: Sir, As one of the authors of the hospital anxiety and depression scale I wish to comment on the study presented by Dowell and Biran (January Journal, p.27). Their study misinterpreted the purpose of the hospital anxiety and depression scale. It was devised as a clinical guide as to whether depression and/or anxiety may be contributing to the distress of patients attending non-psychiatric departments of general hospital clinics. Its purpose was not to rival the general health questionnaire' as a screening instrument for otherwise undefined 'cases' of psychiatric disorder. The two sub-scales of the hospital anxiety and depression scale must therefore be considered separately and it is unfortunate that their study has reproduced the error of an earlier study2 which presented data in terms of the summation of the scores on the two subscales, using an arbitrary score for definition of the supposed 'cases'. The statement by Dowell and Biran concerning the detection of 50%o of cases in their sample is therefore invalid. As regards the data in their Table 1, the finding that 10% of the 394 consulting sample (11+29) may be suffering from an associated, or primary, depressive state and 26% (25 + 76) from an anxiety state are not unrealistic estimates. It is important to bring to attention some further characteristics of the hospital anxiety and depression scale. Previous self-assessment instruments were either too long for convenient clinical use, presented concepts of 'depression' and 'anxiety' partly in terms of somatic symptoms thus rendering them less useful in physically ill patients, failed to differentiate the concepts of anxiety and depression or lacked instructions for interpretation of scores. The hospital anxiety and depression scale has attempted to overcome these defects. The general concept of 'depression' is overinclusive since the term is used to cover a wide variety of states of misery or unhappiness and, in devising the hospital anxiety and depression subscale we concentrated on the construct of anhedonia since this provides the clinician with the nearest clinical marker for the biogenic (antidepressant responsive) depressive state.3 Finally, may I take the opportunity to advise readers on the availability of the scale? To date it has been made available to users in the UK and Eire by the Medical Liaison Service of Upjohn. This good service must now unfortunately end but users may obtain a copy for subsequent photocopy by stamped addressed envelope from myself.